# European basic laparoscopic urological skills: a feasibility study in a setting for robot-assisted surgery

## TL;DR

This study shows that basic laparoscopic skills training can be adapted for robot-assisted surgery, helping new surgeons develop necessary skills in a cost-effective way.

## Contribution

The study evaluates the feasibility of adapting E-BLUS tasks for robot-assisted surgery training, a novel application of existing surgical training methods.

## Key findings

- Experienced and novice surgeons showed significant differences in time performance for fine surgical tasks like cutting and knotting.
- No significant difference was found in tasks requiring manual ambidexterity between experienced and novice surgeons.
- Novice surgeons had a low failure rate when performing the E-BLUS tasks in robot-assisted settings.

## Abstract

Since the introduction of laparoscopy, a variety of training sets and tasks have been introduced for surgical education of minimally-invasive surgery. The implementation of the European Basic Laparoscopic Urological Skills into the training and education program of future laparoscopic surgeons created a new era and provided a standardized approach for urological surgical training. However, these tasks have not yet been evaluated in a setting of robot-assisted surgery. The aim of this study is to evaluate the feasibility of the implementation of the four E-BLUS tasks into training modules of robot-assisted surgery.

A cohort of 31 robotic surgeons (group A: experienced, group B: novices) performed these tasks in two different institutions by using the latest generation of robotic surgical platforms. Time performance and failure rate were assessed and statistically analyzed.

The groups demonstrated a statistically significant difference regarding time performance in half of the tasks involving fine surgical skills (cutting and knotting, p = 0.01 and p = 0.02, respectively) but no significant difference in tasks involving manual ambidexterity (p = 0.14 and 0.12, respectively). A low failure rate during the attempts of the group of novice robotic surgeons could be observed.

The use of the E-BLUS tasks in a training setting of robot-assisted surgery is feasible and can lead to the development of surgical skills needed during robot-assisted surgical procedures. It is a relatively low-cost dry lab option for the introduction of novice robotic surgeons.